Can you get Social Security disability for Diabetes?

Practicing Social Security Disability law in Indianapolis has opened my eyes to how many people suffer from diabetes. Many of my clients suffer from several different disabling conditions at the same time, and more often than not, diabetes is on their list. Since there can be so many varying degrees of severity, I try to find out how it affects each individual client regarding their ability to work.

What diabetes is

Diabetes mellitus, or simply diabetes, occurs when glucose in the bloodstream cannot be moved into the body’s cells for energy, so blood glucose stays at an unacceptably high level. There are two main types. Type 1 diabetes comes from the body’s inability to produce insulin, and people with this condition typically inject insulin or wear an insulin pump. Type 2 diabetes stems from the body’s resistance to insulin, meaning the cells cannot properly use the insulin that is there.

Type 1 is an autoimmune condition that often appears in childhood or adolescence, and symptoms can come on within a matter of weeks, sometimes triggered by an infection. Most people who develop Type 1 have no family history of it. Type 2 develops gradually, and symptoms may come on slowly or go unnoticed for years. Risk factors for Type 2 include genetics, weight, diet, and physical inactivity. Type 2 was once called adult-onset diabetes, but that name has fallen out of use because it now appears in children and adolescents as well.

Some symptoms of diabetes may include:

• Frequent urination
• Increased thirst
• Increased hunger
• Unexplained weight loss
• Fatigue
• Numbness and tingling in the hands and feet
• Blurred vision
• Skin rashes and slow-healing sores

There is no known cure for diabetes. It can often be controlled with medication and lifestyle changes, but sometimes, in spite of the patient’s best efforts, symptoms persist. Some patients have other medical conditions that prevent them from tolerating the necessary medication or from keeping up with an exercise program. Consistent access to treatment and medication is another hurdle many patients face because of a lack of insurance and financial resources.

Why there is no listing for diabetes

The Social Security Administration (SSA) addresses diabetes in Section 9.00, Endocrine Disorders, of its Listing of Impairments. What catches many claimants off guard is that diabetes is no longer a listed impairment. Social Security removed the diabetes listing in 2011, on the basis that it was no longer accurately identifying people who were disabled.

This does not mean diabetes cannot support a claim. It means simply having a diagnosis of diabetes is not enough to meet Social Security’s definition of disability. Your diabetes must cause functional limitations that prevent you from performing work activities on a regular and continuing basis.

Social Security explains how it evaluates the disease in a policy ruling called SSR 14-2p, Evaluating Diabetes Mellitus. That ruling is worth knowing about, because it is the document your claim will actually be measured against.

There is one exception worth knowing about. When Social Security removed the adult and childhood diabetes listings, it added listing 109.08 for children from birth to age six who have any type of diabetes and require daily insulin. For that age group, the diagnosis together with the need for daily insulin is enough to meet the listing. Once a child turns six, the claim is evaluated the same way an adult’s is, on what the disease has done.

Complications that may meet another listing

Diabetes may cause complications that are severe enough by themselves to meet or equal one of Social Security’s other listings. Rather than looking for a diabetes listing, the agency looks at the body system the damage has affected. Here are examples drawn from SSR 14-2p and the effects of chronic high blood sugar:

• Diabetic peripheral neuropathy, evaluated under Section 11.00, Neurological Disorders, including listing 11.14 for peripheral neuropathies
• Diabetic retinopathy and other vision loss, evaluated under Section 2.00, Special Senses and Speech, including listings 2.02, 2.03, and 2.04
• Amputation, often following diabetic peripheral neurovascular disease and gangrene, evaluated under Section 1.00, Musculoskeletal Disorders, under listing 1.20
• Coronary artery disease, peripheral vascular disease, cardiac arrhythmias, heart failure, hypertension, and chronic venous insufficiency, evaluated under Section 4.00, Cardiovascular System
• Diabetic gastroparesis and ischemic bowel disease, evaluated under Section 5.00, Digestive Disorders
• Diabetic nephropathy and chronic kidney disease, evaluated under Section 6.00, Genitourinary Disorders
• Slow-healing bacterial and fungal skin infections, evaluated under Section 8.00, Skin Disorders
• Cognitive problems, depression, anxiety, and eating disorders, evaluated under Section 12.00, Mental Disorders

Severe episodes at either end of the blood sugar range can also cause listing-level damage. Diabetic ketoacidosis from very high blood sugar can lead to cardiac arrhythmias, intestinal necrosis, and cerebral edema with seizures. Hypoglycemia, when blood sugar drops too low, can cause seizures, loss of consciousness, altered mental status, and lasting cognitive deficits. The SSA must consider all of your symptoms from diabetes, including the ones that occur when your blood sugar is too low.

Neuropathy is usually the reason people cannot work

In my practice, the most common reason my diabetic clients find themselves unable to work is the tingling or burning known as neuropathy in their hands and feet. Diabetic neuropathy is nerve damage that commonly affects the legs, feet, and hands. Many people describe pain, burning sensations, tingling, or numbness, and as the condition progresses, sores and ulcers may develop.

The inability to stand and walk can greatly reduce the number and types of jobs a person can perform. Many of my clients with neuropathy or swelling in their legs and feet cannot sit for very long without pain, and they need to elevate their legs to relieve it. Some need a cane or walker to balance or walk. When neuropathy affects the hands, holding items and using the fingers becomes difficult, which rules out work requiring fine or gross manipulation.

If your diabetes does not meet a listing

Most diabetes claims are not won at the listing step, and that does not make them weak claims. When no listing is met or equaled, Social Security assesses your residual functional capacity, which is the set of activities you are still able to perform once all of your conditions are taken into account.

My clients commonly describe the same restrictions: they cannot sit or stand for even short periods, they have trouble using their hands on a frequent basis, and they would have difficulty completing an eight-hour workday because of fatigue, pain, and blood sugar they cannot control. If the SSA finds that your capacity to perform work activities is too low, it may find that you cannot work.

Your age, past work experience, and education are also part of that determination. A claimant of 50 or older with no transferable skills is in a considerably stronger position than a younger claimant with identical limitations, and at 55 the vocational rules shift again in the claimant’s favor. Since June 22, 2024, Social Security also looks only at work performed in the previous five years rather than fifteen.

Tell Social Security about every condition you have

At your disability hearing in front of the Administrative Law Judge (ALJ), the judge is required to consider all of your severe impairments when determining whether you are disabled. Social Security bases your limitations on the combination of all functional limitations resulting from any and all medically determinable impairments you have.

This matters because diabetes rarely arrives alone. Many of my clients have impairments that increase the risk of developing diabetes, such as cardiovascular disease, high blood pressure, or high cholesterol. Others develop risk factors like weight gain and physical inactivity because of the physical limitations their other conditions already cause.

So even if you do not consider diabetes to be your most disabling condition, its effects on your ability to work may be substantial. Let your attorney or representative know if diabetes contributes to your inability to work. I talk to my clients extensively about how diabetes keeps them from working so I can better understand their limitations and present them to the judge.

Treatment compliance, and what to do if you cannot afford treatment

Most judges pay close attention to whether you are following your prescribed treatment. If the judge concludes that your symptoms are the result of not taking your insulin as prescribed, they may find those symptoms preventable, and therefore not truly what is keeping you from working.

There is an important qualification here that often goes unmentioned. Social Security cannot deny your claim for failing to follow prescribed treatment unless that treatment would be expected to restore your ability to work, and the agency is required to consider whether you had a good reason for not following it. Being unable to afford medication, testing supplies, or appointments can be a good reason. If cost, transportation, side effects, or a lack of insurance is why you have not been able to follow your treatment plan, say so clearly and make sure it appears in your medical records rather than going unexplained.

Even when you do comply with treatment fully, you may continue to experience severe restrictions. Receiving consistent treatment from a physician who specializes in diabetes, and complying with it, helps demonstrate that your impairment persists despite proper care.

The medical evidence that supports a diabetes claim

It greatly helps your case to have thorough medical records when you go into your Social Security disability hearing, and recent records from a specialist such as an endocrinologist are particularly persuasive, because a specialist’s findings tend to be better supported and more detailed. Most of my clients with severe diabetes have substantial records, simply because the disease requires so much monitoring and treatment.

Objective testing matters as much as the treatment notes. Useful evidence includes:

• Blood work showing your glucose levels over time
• Nerve conduction studies establishing that numbness and pain in the arms or legs is caused by neuropathy
• Eye exams showing that vision problems are caused by retinopathy
• Kidney function testing where nephropathy is at issue

It may also be in your best interest to obtain a medical source statement from your treating provider. Your doctor’s opinion about your specific limitations with standing, walking, sitting, and lifting, presented alongside your medical records, is often what persuades the SSA how severe your condition really is.

Talk with an Indiana disability attorney about your diabetes claim

The fight against the symptoms of diabetes is a constant and lifelong struggle, and the disability process itself can be long and confusing. I encourage my clients to ask questions about how the SSA will evaluate their claim.

If diabetes or any other medical condition is preventing you from working to support yourself or your family, it may be in your best interest to file an initial application and then follow through with any appeals that are necessary. Keep in mind that you generally have sixty days from the date on the notice to appeal, and missing that deadline can cost you benefits you would otherwise be entitled to.

Most Social Security disability law firms, including mine, offer a free consultation to evaluate your case.